| Abdomen 1 View (74018) |
$363 |
$363 |
3.8× |
| Abdomen 2 views (74019) |
$294 |
$294 |
2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,380 |
$2,380 |
5.4× |
| Ankle 2 views (73600) |
$359 |
$359 |
3.7× |
| Bone age studies (77072) |
$1,118 |
$1,118 |
9.6× |
| Bone Imaging 3 Phase (78315) |
$2,378 |
$2,378 |
5.4× |
| Bone Imaging Whole Body (78306) |
$1,712 |
$1,712 |
3.9× |
| Chest 1 view (71045) |
$237 |
$237 |
2.5× |
| Chest 2 views (71046) |
$404 |
$404 |
4.2× |
| Chest 3 views (71047) |
$170 |
$170 |
1.8× |
| Chest 4 or more views (71048) |
$413 |
$413 |
3.6× |
| Clavicle complete (73000) |
$361 |
$361 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,229 |
$6,229 |
16.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,354 |
$4,354 |
16.4× |
| CT abdomen w contrast (74160) |
$2,595 |
$2,595 |
13.3× |
| CT abdomen w wo contrast (74170) |
$3,150 |
$3,150 |
16.2× |
| CT abdomen w/o contrast (74150) |
$2,143 |
$2,143 |
18.4× |
| CT Angio Abdomen and Pelvis (74174) |
$7,577 |
$7,577 |
19.5× |
| CT Angio Chest (71275) |
$4,238 |
$4,238 |
21.7× |
| CT Angio Head (70496) |
$3,779 |
$3,779 |
19.4× |
| CT angio hrt w/3d image (75574) |
$2,052 |
$2,052 |
5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,912 |
$2,912 |
14.9× |
| CT Angio Neck (70498) |
$3,462 |
$3,462 |
17.8× |
| CT cervical spine w/ contrast (72126) |
$2,594 |
$2,594 |
6.7× |
| CT cervical spine w/o contrast (72125) |
$2,220 |
$2,220 |
19.1× |
| CT cervical spine w/wo cont (72127) |
$4,807 |
$4,807 |
24.7× |
| CT chest w contrast (71260) |
$2,591 |
$2,591 |
13.3× |
| CT chest w/wo contrast (71270) |
$3,237 |
$3,237 |
16.6× |
| CT head/brain with contrast (70460) |
$1,973 |
$1,973 |
10.1× |
| CT head/brain without and with contrast (70470) |
$2,632 |
$2,632 |
13.5× |
| CT iac w contrast (70481) |
$2,096 |
$2,096 |
10.8× |
| CT lower ext w/o (73700) |
$2,018 |
$2,018 |
17.4× |
| CT lower extremity w/contrast material (73701) |
$2,205 |
$2,205 |
11.3× |
| CT lumbar spine w contrast (72132) |
$2,571 |
$2,571 |
6.6× |
| CT lumbar spine w/o contrast (72131) |
$2,224 |
$2,224 |
19.1× |
| CT maxillofacial w contrast (70487) |
$2,146 |
$2,146 |
11.0× |
| CT maxillofacial wo contrast (70486) |
$1,969 |
$1,969 |
16.9× |
| CT neck tissue combo (70492) |
$3,980 |
$3,980 |
20.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,915 |
$3,915 |
20.1× |
| CT orbits w/o contrast (70480) |
$1,828 |
$1,828 |
15.7× |
| CT pelvis w&w/o contrast (72194) |
$3,083 |
$3,083 |
15.8× |
| CT pelvis w/o contrast (72192) |
$2,217 |
$2,217 |
19.1× |
| CT scan of leg combo (73702) |
$4,094 |
$4,094 |
21.0× |
| CT scans face/jaw combo (70488) |
$3,857 |
$3,857 |
19.8× |
| CT soft tissue neck w contrast (70491) |
$2,146 |
$2,146 |
11.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,839 |
$1,839 |
15.8× |
| CT thoracic spine w contrast (72129) |
$2,279 |
$2,279 |
11.7× |
| CT thoracic spine w/o contrast (72128) |
$2,169 |
$2,169 |
18.7× |
| CT thorax w/o contrast (71250) |
$2,185 |
$2,185 |
18.8× |
| CT upper ext wo (73200) |
$2,071 |
$2,071 |
17.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,123 |
$4,123 |
21.1× |
| CT upper extremity with contrast (73201) |
$2,429 |
$2,429 |
6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,317 |
$5,317 |
27.3× |
| Cta Abdomen (74175) |
$4,122 |
$4,122 |
21.1× |
| CTA pelvis (72191) |
$3,460 |
$3,460 |
17.7× |
| Dxa Bone Density Axial (77080) |
$627 |
$627 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$698 |
$698 |
7.2× |
| Fetal Biophys Profile W/Nst (76818) |
$992 |
$992 |
8.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$450 |
$450 |
3.9× |
| Fluoroscopy up to 1 hr (76000) |
$740 |
$740 |
2.8× |
| Foot 2 views (73620) |
$321 |
$321 |
3.3× |
| Forearm 2 views (73090) |
$256 |
$256 |
2.6× |
| Gastric emptying imaging study (78264) |
$1,968 |
$1,968 |
4.4× |
| Gated Heart Planar Single (78472) |
$1,597 |
$1,597 |
3.6× |
| Hand 2 views (73120) |
$404 |
$404 |
3.5× |
| Hepatobil Syst Image W/Drug (78227) |
$3,188 |
$3,188 |
5.3× |
| Hepatobiliary System Imaging (78226) |
$2,331 |
$2,331 |
5.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,434 |
$2,434 |
1.7× |
| K Flow/Funct Image W/Drug (78708) |
$1,126 |
$1,126 |
1.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,570 |
$1,570 |
2.6× |
| Knee 3 Views (73562) |
$439 |
$439 |
4.5× |
| Magnetic Image Jaw Joint (70336) |
$3,557 |
$3,557 |
13.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$7,637 |
$7,637 |
19.7× |
| MRA head w/o contrast (70544) |
$3,314 |
$3,314 |
12.5× |
| MRA head with contrast (70545) |
$3,631 |
$3,631 |
9.4× |
| MRA neck w contrast (70548) |
$3,215 |
$3,215 |
8.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,784 |
$6,784 |
17.5× |
| MRA neck w/o contrast (70547) |
$3,015 |
$3,015 |
11.4× |
| MRI abdomen w contrast (74182) |
$3,821 |
$3,821 |
9.9× |
| MRI abdomen w/o contrast (74181) |
$3,378 |
$3,378 |
12.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,915 |
$3,915 |
4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$6,575 |
$6,575 |
17.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,356 |
$4,356 |
5.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,268 |
$2,268 |
8.6× |
| MRI cervical spine w contrast (72142) |
$3,915 |
$3,915 |
10.1× |
| MRI cervical spine w/o cont (72141) |
$3,234 |
$3,234 |
12.2× |
| MRI chest w/o contrast (71550) |
$3,324 |
$3,324 |
12.5× |
| MRI chest with contrast (71551) |
$3,915 |
$3,915 |
4.5× |
| MRI chest wo w contrast (71552) |
$7,637 |
$7,637 |
19.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,646 |
$3,646 |
9.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$7,345 |
$7,345 |
18.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,495 |
$3,495 |
13.2× |
| MRI lumbar spine w contrast (72149) |
$4,516 |
$4,516 |
11.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,334 |
$4,334 |
11.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,997 |
$1,997 |
7.5× |
| MRI orbit face neck w contrast (70542) |
$1,997 |
$1,997 |
5.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$7,679 |
$7,679 |
19.8× |
| MRI pelvis w contrast (72196) |
$4,461 |
$4,461 |
11.5× |
| MRI pelvis w/o & w contrast (72197) |
$7,167 |
$7,167 |
18.5× |
| MRI pelvis w/o contrast (72195) |
$3,397 |
$3,397 |
12.8× |
| MRI spectroscopy (76390) |
$3,527 |
$3,527 |
36.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,378 |
$3,378 |
12.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,915 |
$3,915 |
10.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,495 |
$3,495 |
13.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$7,945 |
$7,945 |
20.5× |
| MRI, abdomen, combo (74183) |
$5,175 |
$5,175 |
13.3× |
| MRI, dorsal spine combo (72157) |
$5,017 |
$5,017 |
12.9× |
| MRI, dorsal spine contrast (72147) |
$3,915 |
$3,915 |
10.1× |
| MRI, joint upper extrem (73221) |
$3,384 |
$3,384 |
12.8× |
| MRI, joint upper extrem combo (73223) |
$7,713 |
$7,713 |
19.9× |
| MRI, lumbar spine combo (72158) |
$7,208 |
$7,208 |
18.6× |
| Myocardial Spect Multiple Studies (78452) |
$3,405 |
$3,405 |
2.4× |
| Neck soft tissue (70360) |
$195 |
$195 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$1,043 |
$1,043 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$385 |
$385 |
3.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$373 |
$373 |
3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$406 |
$406 |
4.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$334 |
$334 |
3.5× |
| Radex elbow complete minimum 3 views (73080) |
$410 |
$410 |
4.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$311 |
$311 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$319 |
$319 |
3.3× |
| Radex foot complete minimum 3 views (73630) |
$410 |
$410 |
4.2× |
| Radex Hand Minimum 3 Views (73130) |
$422 |
$422 |
4.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$206 |
$206 |
2.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$290 |
$290 |
3.0× |
| Radex shoulder complete minimum 2 views (73030) |
$410 |
$410 |
4.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$251 |
$251 |
2.6× |
| Radex Spine 1 View Specify Level (72020) |
$240 |
$240 |
2.5× |
| Radex Sternum Minimum 2 Views (71120) |
$322 |
$322 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$314 |
$314 |
3.2× |
| Radex Toe Minimum 2 Views (73660) |
$318 |
$318 |
3.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$231 |
$231 |
2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$401 |
$401 |
4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$266 |
$266 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$322 |
$322 |
2.8× |
| Radiologic exam knee complete 4/more views (73564) |
$632 |
$632 |
5.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$298 |
$298 |
2.6× |
| Radiologic examination femur 1 view (73551) |
$384 |
$384 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$428 |
$428 |
4.4× |
| Radiologic examination knee 1/2 views (73560) |
$381 |
$381 |
3.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$378 |
$378 |
3.9× |
| Ribs bilateral 3 views (71110) |
$405 |
$405 |
3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,595 |
$2,595 |
4.3× |
| Scapula (73010) |
$263 |
$263 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$211 |
$211 |
9.0× |
| Skull less than 4 views (70250) |
$414 |
$414 |
3.6× |
| Sternoclavicular joints (71130) |
$331 |
$331 |
3.4× |
| Thoracic spine 2 views (72070) |
$460 |
$460 |
4.0× |
| Thoracic spine 3 views (72072) |
$494 |
$494 |
4.3× |
| Thoracolumbar 2 views (72080) |
$452 |
$452 |
4.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,154 |
$1,154 |
2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,154 |
$1,154 |
2.6× |
| Ultrasound Breast Limited (76642) |
$453 |
$453 |
4.7× |
| Ultrasound Exam Aaa Screen (76706) |
$740 |
$740 |
6.4× |
| Ultrasound, abdomen limited (76705) |
$689 |
$689 |
5.9× |
| Us breast unilateral complete (76641) |
$840 |
$840 |
7.2× |
| Us chest (76604) |
$583 |
$583 |
5.0× |
| Us complete joint (76881) |
$624 |
$624 |
5.4× |
| Us exam, pelvic, limited (76857) |
$463 |
$463 |
4.0× |
| Us head (76506) |
$618 |
$618 |
5.3× |
| Us kidney transplant (76776) |
$641 |
$641 |
5.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$593 |
$593 |
5.1× |
| Us ob detailed single fetus (76811) |
$1,013 |
$1,013 |
3.8× |
| Us ob limited 1 or more fetuses (76815) |
$654 |
$654 |
5.6× |
| Us ob transvaginal (76817) |
$672 |
$672 |
5.8× |
| Us pelvic non ob complete (76856) |
$664 |
$664 |
5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,115 |
$1,115 |
9.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$644 |
$644 |
5.5× |
| Us retroperitoneal complete (76770) |
$793 |
$793 |
6.8× |
| Us retroperitoneal limited (76775) |
$562 |
$562 |
4.8× |
| Us scrotum and contents (76870) |
$642 |
$642 |
5.5× |
| Us thyroid (76536) |
$615 |
$615 |
5.3× |
Us transrectal (76872) range across 2 matching MRF lines |
$97–$948 |
$97–$948 |
varies |
| Wrist 2 views (73100) |
$352 |
$352 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$230 |
$230 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$423 |
$423 |
4.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$374 |
$374 |
3.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$459 |
$459 |
3.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$309 |
$309 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$466 |
$466 |
4.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$384 |
$384 |
3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$508 |
$508 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$458 |
$458 |
3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$433 |
$433 |
3.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$675 |
$675 |
5.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$470 |
$470 |
4.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$553 |
$553 |
4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$542 |
$542 |
4.7× |
| X-ray eye for foreign body (70030) |
$214 |
$214 |
2.2× |
| X-ray humerus (73060) |
$368 |
$368 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$407 |
$407 |
4.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$482 |
$482 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$207 |
$207 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$664 |
$664 |
5.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$428 |
$428 |
3.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$360 |
$360 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$373 |
$373 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$303 |
$303 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$365 |
$365 |
3.1× |
| X-ray thoracic spine 4 vw (72074) |
$315 |
$315 |
2.7× |
| X-Rays Bone Length Studies (77073) |
$371 |
$371 |
3.2× |
| X-Rays Bone Survey Complete (77075) |
$699 |
$699 |
6.0× |
| Xr c-spine 4 or 5 views (72050) |
$513 |
$513 |
4.4× |
| Xr facial bones less than 3 views (70140) |
$256 |
$256 |
2.6× |
| Xr orbits complete 4 views (70200) |
$311 |
$311 |
2.7× |